Computers have had a pervasive impact on contemporary life, an impact that has been felt strongly in educational assessment. Interestingly, although the potential advantages of computerized testing have been studied and discussed for more than two decades, it is only within the last few years that computers have begun to have a large-scale practical impact on assessment. This chapter will examine the role of computers in medical education assessment. The chapter is broadly divided into three sections. The first examines the use computers as a platform for the delivery of standard testing formats (e.g. multiple-choice items). In this application, the computer eliminates costs associated with printing test materials, allows for enhancements such as audio and video, and may allow for increased flexibility in scheduling and administration. The computer also facilitates the implementation of various types of adaptive testing. Computer-adaptive testing (CAT) is a means of improving the efficiency of testing by targeting the test to the individual examinee. Most computer-adaptive testing procedures are based on item response theory (IRT). A brief (and relatively non-mathematical) description of IRT will be presented followed by a discussion of the logic and potential of CAT. This section will end with a description of some recent innovations related to computerized testing, including alternative item selection and test construction methodologies and procedures for automated test assembly.
The second section of this chapter will focus on computer simulations for use in The second section assessment. As with other aspects of computer-based testing, discussion, planning and research date back decades but results from large-scale implementation are only now becoming available. This section begins with an historical perspective, of the computer simulation, the paper-and-pencil based describing the precursor of currently available simulations are patient management problem. Two examples described. A significant question with the use of computerized patient management is, “How should the performance be scored”? A conceptual framework simulations for considering scoring approaches is described and recent published results are for assessments based on summarized. Validity and reliability issues are discussed computerized simulations.
The third section of this chapter briefly describes what may be the future of computers in assessment. Research in the areas of natural language processing and for sensible speculation about the potential for the virtual reality provide a basis use of technology in future assessment. Recommendations are made to temper enthusiasm so that technology may be a means to improved assessment rather than an end in itself.
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